Integumentary System Commons^™

Selective Retention Of Birdshot Pellets In The Rearfoot: A Case Demonstrating Tissue Preservation And Functional Recovery, Yasim Zafar, Steven Bolton, Alexandria Armstrong, Hooman Mir

School of Podiatric Medicine - Student Research

Level of Evidence: III (Case Study)

Statement of Purpose: Gunshot wounds to the foot pose a unique surgical dilemma—whether to pursue aggressive foreign body removal or to preserve soft tissue integrity. This case highlights the management of a birdshot injury to the rearfoot where selective non-removal of pellets near the neurovascular bundle led to complete healing and full functional recovery. The purpose is to emphasize tissue preservation over aggressive exploration in complex ballistic foot injuries.

Case Study: A 26-year-old female sustained a birdshot gunshot wound to the right rearfoot. Multiple small entry wounds were noted on the posterior and plantar …

Successful Management Of Generalized Pustular Psoriasis With Cyclosporine In Hiv-Infected Patient, Rasinta Ayudya Deltania, Anggun Putri Yuniaswan

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Generalized pustular psoriasis (GPP) can be associated with human immunodeficiency virus (HIV) infection, making its management more challenging and complex. This case report aims to evaluate the effectiveness and safety of cyclosporine in HIV-associated GPP.

Case illustration: A 31-year-old male with a six-year history of HIV on antiretroviral therapy presented with rapidly spreading erythematous plaques with scaling and patches, along with “lakes of pus”, involving 50% of the body surface area (BSA). He reported oral burning, dysgeusia, and odynophagia; tongue Gram stain showed budding yeast and pseudohyphae. The patient was diagnosed with GPP and oral candidiasis in the setting …

Case Report: A Case Of Transient Dress Syndrome (Drug Rash With Eosinophilia And Systemic Symptoms), Dip Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 41-year-old female with a history of hypertension who presented with fever and a diffuse erythematous rash after taking trimethoprim-sulfamethoxazole (TMP-SMX) for an ear infection. Due to her symptoms, mild eosinophilia, and elevated liver function tests, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) was suspected. Although the patient’s rash had resolved by the time of initial evaluation, it recurred overnight, reinforcing suspicion for DRESS syndrome. TMP-SMX was discontinued, and acetylcysteine was administered due to the patient’s high-dose use of acetaminophen in the days prior to her hospital presentation. Infectious and autoimmune workups were negative. …

Photodynamic Therapy Vs. 5-Fluorouracil For Field-Directed Treatment Of Actinic Keratosis: A Comparative Literature Review, Bhumik Patel

Rowan-Virtua Research Day

BACKGROUND: Actinic keratosis (AK) is a common precancerous skin condition arising from chronic UV exposure and often involves field cancerization, where visible lesions coexist with subclinical damage. Effective field-directed treatments are critical for preventing progression to squamous cell carcinoma.

HYPOTHESIS: Photodynamic Therapy (PDT) may offer superior efficacy, cosmetic outcomes, and patient adherence compared to topical 5-Fluorouracil (5-FU), despite its higher cost and clinical setting requirement.

METHODS: This literature review analyzed peer-reviewed studies from 2015–2025 comparing PDT and 5-FU for field-directed AK treatment. Outcomes assessed included lesion clearance, recurrence, tolerability, adherence, cost, and patient satisfaction.

RESULTS: PDT demonstrated high clearance rates …

Acne And The Cutaneous Microbiome: A Systematic Review Of Mechanisms And Implications For Treatments, Alicia Podwojniak, Isabella J Tan, John Sauer, Zachary Neubauer, Hanna Rothenberg, Hira Ghani, Aarushi K Parikh, Bernard Cohen

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Acne vulgaris is a pervasive skin disease characterized by inflammation of sebaceous units surrounding hair follicles. It results from the complex interplay between skin physiology and the intricate cutaneous microbiome. Current acne treatments, while effective, have major limitations, prompting a shift towards microbiome-based therapeutic approaches. This study aims to determine the relationship between acne and the cutaneous microbiome, assess the effects of current treatments on the cutaneous microbiome and explore the implications for developing new therapies. A systematic review was performed using PubMed and SCOPUS databases within the last 10 years. Methodological quality was assessed independently by two authors. The …

The Efficacy Of Baricitinib As A Treatment Option For Alopecia, In Terms Of Promoting Hair Regrowth And Improving Patient Reported Outcomes, Bhaumik Patel, Abhiram Gollapudi, Samrat Gollapudi, Srinidhi Banala, Brian Joseph Mathew, Prince Patel

Rowan-Virtua Research Day

Background: Alopecia, an autoimmune condition characterized by hair loss, significantly impacts millions globally, often leading to psychological distress such as anxiety and depression. Current treatments are variably effective and frequently associated with adverse effects that restrict long-term use. This study evaluates the efficacy of Baricitinib, a Janus Kinase inhibitor, in treating severe alopecia, focusing on hair regrowth and patient-reported outcomes.

Methods: This research synthesized data from recent publications (2018-2023) including clinical trials, reviews, meta-analyses, and systematic reviews, sourced from databases such as PubMed, Springer, and Elsevier. The inclusion criteria focused on recent studies in English evaluating Baricitinib's effectiveness in severe …

Janus Kinase (Jak) Inhibitors: A New Frontier In The Treatment Of Vitiligo, Catherine F. Alapatt, Amanda Greenspan, Mohammad Fardos

Rowan-Virtua Research Day

Up to 70 million people worldwide suffer from vitiligo, an autoimmune disease characterized by the destruction of melanin. Current treatment options vary in efficacy. The disease manifests clinically as white circular macules of depigmentation seen primarily on the face and appendages.1 The pathophysiology of vitiligo is multifactorial and still being studied. One proposed mechanism behind the pathophysiology of vitiligo involves the upregulation of interferon gamma (IFN-γ) with downstream effects on JAK/STAT pathways resulting in CXCL10 transcription.1,2 Here we discuss Ruxolitinib, a topical JAK inhibitor, that recently passed its clinical trial phase, and Ritlecitinib, an oral JAK inhibitor which is currently …

The Role Of Protein Kinase C Epsilon In Hydrogen Peroxide And Nitric Oxide Release During Oxidative Stress Caused By Extracorporeal Shockwave Lithotripsy, Edward S. Iames

PCOM Biomedical Studies Student Scholarship

Clinical extracorporeal shock wave lithotripsy (ESWL) treatment to ablate kidney stones can cause acute damage to the renal microvasculature. Accumulation of continued treatment with shockwave therapy can lead to chronic damage to the kidney, and lead to clinical hypertension. Shockwaves have been shown to stimulate endothelial cells to release superoxide (SO), which is converted to hydrogen peroxide (H₂O₂), and reacts with nitric oxide (NO) to produce peroxynitrite anion (OONO^-), creating a powerful oxidant that increases oxidative stress while simultaneously reducing NO bioavailability. Increased oxidative stress during events such as ESWL, also uncouples NO production …